영유아에서청성뇌간반응과청성지속반응의역치비교

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1 KISEP Otology Korean J Otolaryngol 2004;47: 영유아에서청성뇌간반응과청성지속반응의역치비교 동아대학교의과대학이비인후과학교실 김리석 정성욱 허승덕 황찬호 Comparison of Auditory Brainstem Response and Auditory Steady-State Response Thresholds in Infants and Young Children Lee-Suk Kim, MD, Sung-Wook Jung, MD, Seung-Deok Heo, MA and Chan-Ho Hwang, MD Department of Otolaryngology and Head & Neck Surgery, College of Medicine, Dong-A University, Busan, Korea ABSTRACT Background and Objectives:The aim of this study was to assess the accuracy of threshold estimates determined by the auditory steady-state response (ASSR) in a group of sedated infants and young children with a range of hearing losses. Materials and Method:Two studies were performed because the behavioral audiometric information was not available from infants and young children. In the first study, a retrospective analysis was performed for 36 children (mean age:3 years 4 months) who had completed auditory brainstem response (ABR) and pure tone audiometry to verify that ABR threshold is a good predictor for pure tone threshold in our laboratory. The ABR thresholds to, 1 Hz tone-pip and click were compared with behavioral thresholds. In the second study, a prospective analysis of 23 children (mean age:12 months), the ABR thresholds to, 1 Hz tone-pip and click were compared with ASSR thresholds to amplitude and frequency modulated tones. Results:The first study in which strong correlations were found between ABR and pure tone thresholds (r 0.92) demonstrated that ABR thresholds could be used to predict the pure tone thresholds. The second study which showed that ASSR thresholds were highly correlated with ABR thresholds (r 0.93) indicated that ASSR thresholds provided reliable audiometric information in infants and young children. Conclusion:These studies showed that ASSR could be used to estimate hearing thresholds with reliable accuracy in infants and young children. (Korean J Otolaryngol 2004;47:304-10) KEY WORDS:Auditory brainstem response Auditory steady-state response

2 김리석외 - 대상 방법 - 대상 방법 305

3 청성뇌간반응과청성지속반응의역치비교 A B ABR threshold dbnhl 11 ears y1.10x9.8 r0.98, p C 2 khz 47 ears y1.09x6.5 r0.94, p PTA threshold dbhl 37 ears y1.19x11.5 r0.93, p D 47 ears y1.11x5.8 r0.92, p /4 khz average Fig. 1. The relationship between auditory brainstem response thresholds in dbnhl and pure tone thresholds in dbhl. The numbers of ears involved, regression equations, and correlation coefficients are given in the right lower of each panel. AThe relationship between the tone-pip ABR and the PTA thresholds. BThe relationship between the tone-pip ABR and the PTA thresholds. CThe relationship between the click ABR and the 2 khz PTA thresholds. D The relationship between the click ABR thresholds versus the 2 khz to 4 khz average thresholds for PTA. tone-pip tone-pip 0.1V 0.1V 0.1V 70 db 70 db 90 db 50 db 30 db 20 db 10 db 05 db msec 50 db 30 db 10 db 5 db msec 70 db 50 db 30 db 20 db 10 db 5 db msec Fig. 2. Auditory brainstem response waveforms recorded from a 6-month old female. The thresholds were judged to be 10 dbnhl for each of the three stimuli. 306 Korean J Otolaryngol 2004;47:304-10

4 김리석외 A B Fig. 3. Auditory steady-state response results recorded from a 3-month old male. The left panel is vector view showing the amplitude and relative phase of the spectral component equal to the modulation frequency. The right panel is probability view showing the probability that the patient s response is either phase-locked phase coherent or random non-phase coherent with the stimulus. APhaselocked response. BRandom result. ASSR threshold dbhl 2 khz 18 ears y0.95x20.2 r0.93, p A C 31 ears y1.09x11.1 r0.95, p khz average 38 ears y1.09x13.0 r0.95, p ABR threshold dbnhl B D 19 ears y1.02x13.2 r0.96, p0.1 Fig. 4. The relationship between auditory brainstem response thresholds in dbnhl and auditory steady-state response thresholds in dbhl. The numbers of ears involved, regression equations, and correlation coefficients are given in the right lower of each panel. AThe relationship between the tone-pip ABR and the ASSR thresholds. B The relationship between the tone-pip ABR and the ASSR thresholds. CThe relationship between the click ABR and the 2 khz ASSR thresholds. DThe relationship between the click ABR thresholds versus the 2 khz to 4 khz average thresholds for ASSR. 307

5 청성뇌간반응과청성지속반응의역치비교 Korean J Otolaryngol 2004;47:304-10

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